README FIRST
: Many have asked for a simple form letter that could just be printed out,
signed and mailed.Thebad news is that legislators pay little attention to
three type of political activism -- petitions, emails and form
letters -- they consider them a type of "junk mail" that
does not represents a passionately committed constituency.

So I'm
posting a 'next generation' form letter -- a 'Chinese menu' template
with two or three choices for each category so that people can cut and
paste one-of-a-kind form letter. Writers may also go to the
Letter Archive, read the correspondence already sent, use any of those
ideas or cut and paste text from those sources to their own unique
letter.

However, for those who just don't have the time
for the build-your-own version, click the link below for a real,
sure-enough form letter. Be sure to delete the
heading (red type) and add your name before printing.

(1)I/we am/are writing on behalf of the Consortium for Evidence-base practice of Obstetrics
(CEO), which is
committed to reforming our maternity care policy and dedicated to bringing
science-based maternity care to all childbearing women.

(2)This letter is on behalf of
the Consortium for Evidence-base practice of Obstetrics. I/we support
the goals of the C.E.O.
to establish physiological management as the standard of care in California
for all healthy women with normal pregnancies.
We need public dialog to bring
about appropriate changes in our national maternity care policy and reform
potentially harmful obstetrical practices.

(3)
Physiological
management of birth is an important issue to women and one that get little
notice in the newspaper and television. The Consortium for Evidence-base practice of Obstetrics
(CEO)
challenges the obstetrical opinion that childbirth in a healthy woman is
fundamentally flawed and must be conducted as a medical or surgical procedure.

On the contrary,

physiological management is the evidenced-based
model of maternity care and is associated with the lowest rate of
maternal and perinatal mortality and the greatest wellbeing of mother and
baby.

I /we am/are deeply
concerned about the ever-increasing medicalization of normal, healthy
women by the obstetrical profession. Modern obstetrics does not improve
outcomes for healthy women and their babies, which is 70% of the
childbearing population.
Obstetrical intervention for healthy women is not scientifically based. Unscientific care raises the cost of normal
childbirth to a staggering proportion of our healthcare budget.As a
result, our current maternity care system fails to meet the needs of
healthy childbearing women, practitioners, taxpayers or society.

This a crisis for
our daughters, granddaughter and all young women. They may never even
have the chance to have a normal vaginal birth or if they do, they risk being
permanently harmed as a result of the the obstetrical
profession's faulty understanding of normal birth
and by the routine use of damaging medical and surgical interventions, episiotomy
and instruments such as forceps or vacuum extraction.

(2)Women’s
rights regarding health care being eroded:

I/we believe that women’s
rights regarding their health care are being constantly eroded by the
non-scientific practice of obstetrics. Conventional
obstetrics practices, especially as they apply to normal labor and birth,
are not based on scientific principles.
The medicalization of vaginal birth is known to cause stress incontinence and other
long-term problems and yet the obstetrical profession doesn't seem to
notice the connection between their drastic interventions in normal birth and
the high rate of damage to maternal tissue. The ever-increasing
Cesarean and maternal mortality rate is even a greater problem. We need public dialog to bring
about appropriate changes in our national maternity care policy and reform
potentially harmful obstetrical practices.

The obstetrical
profession has veered very far from common sense and science-based
maternity care. The American College of Obstetricians and
Gynecologists’ is publicly claiming that Cesarean section is safer and
better for mothers and babies than normal spontaneous birth. According to ACOG, it
is now considered "ethical" for
obstetricians to perform purely elective – that is, medically
unnecessary or the so-called “maternal choice” -- cesarean
surgery. Many obstetricians predict that cesarean will
completely replace normal birth within the next 10 or 15 years as the
official standard of care. For this and other reasons, it is my
observation that
contemporary obstetrics is failing in its most important job --
preserving and protecting already healthy childbearing women from the
excesses of the medical system.

(3)Health care
crisis and fiscal
disaster:

There is a health care crisis in California and all across this
country that nobody is talking about. I am referring to the
extremely serious
problems that healthy childbearing
families, post-cesarean mothers, hospital-based nurse-midwifery programs
and professional midwives all face under our highly politicalized and
deeply dysfunctional obstetrical system. Interventionist obstetrics as
applied to virtually all healthy women introduces artificial and
unnecessary harm. This unscientific care raises the cost of normal
childbirth, eating up far more than a fair or appropriate share of our healthcare budget.

Forty percent of all
childbirth services are paid for out of public funds. Interventionist
obstetrics misdirects approximately 14% of our total health care budget
(2.4% of GNP) to healthy women. It also systemically creates expensive,
often long-term iatrogenic complications. This is a fiscal disaster that
reduces medical services to the ill, injured and elderly; the increased
tax burden and inflated cost of employee health insurance also reduces job
growth and the ability of California businesses to compete in the global
economy. We need public
dialog to bring about appropriate changes in our national maternity care
policy and reform potentially harmful obstetrical practices.

D
- Examples
of the problem or contrasts with appropriate care ~ choose one or two :

(1)Even though we pour
more money into obstetrical services than any other in the world, the United States is
a shameful 25th in the world for infant mortality and 30th for
maternal mortality. Mortality for mothers, and in 2002 for newborns, has
actually rising in our wealthy country in recent years.

(2)My experience providing labor support to women
in a hospital setting opened my eyes and I was shocked by what I saw.
Woman are being instructed to push so hard at the moment of birth that they
tear. Women are restricted to certain positions for actual birth that
makes it hard for them to birth their children in a normal, physiological
way. I saw women scared into accepting certain procedures such as
cesarean birth, because their babies showed distress signals on the fetal
monitor and yet these babies were actually healthy and born completely
normal. Residents told women they weren’t progressing quickly enough (one
centimeter an hour) and so would need
Pitocin to speed things up. This increased
these women’s distress and difficulty in giving birth normally.

(3)
Obstetricians need to hear from women and explain why, after 14 years of
medical school, they can’t facilitate a
normal
spontaneous vaginal birth, without first
subjecting the mother to painful
medical and surgical interventions. What's missing is the use of
physiologic principles. Physiological management is the evidenced-based
model of maternity care. It is associated with the lowest rate
of maternal and perinatal mortality, is protective of the mother's pelvic
floor, has the best psychological outcomes and the highest rate of
breastfed babies. Use of physiological principles results in the fewest
number of medical interventions, lowest rates of anesthetic use,
obstetrical complications, episiotomy, instrumental deliveries, Cesarean
surgery, post-operative complications, delayed and downstream
complications in future pregnancies.

(1)We need to bring the attention
of the public and the legislature to the dysfunctional and wasteful nature
of the current obstetrical system for healthy women and establish
a forum for public dialogue with obstetricians regarding the potentially harmful &
unscientific practices of contemporary obstetrical care, especially as
applied to healthy women, and the great need for reforming the maternity
care policies.

Reforming
our national health care policy would integrate physiological principles
with the best advances in obstetrical medicine to create a single,
evidence-based standard for all healthy women.
This would required medical schools to teach the philosophy, principles and skills of
physiological management to medical students, practicing physicians to learn
and use the strategies of physiological management and insurance companies
to reimburse obstetricians for this safe and cost-effective care.

(2) Were physiological management
of birth to becomes the standard of practice in
California,
like it is many other western nations,
C.E.O. members believe that it would :

Increase the
safety of childbirth and the level of wellness for both the mother and
baby.

Reduce the number of unnecessary and cost-added medical interventions
including cesarean-sections, thereby lowering medical
costs, insurance premiums and taxes.

Enable low income
women, particularly those in rural, inner-city and migrant populations who are served by welfare programs,
to obtain better prenatal and delivery care.

Assist in restoring women as the primary providers of assistance to
women in childbirth.

Give women
appropriate choice
and control in their maternity care.

(3) Physiological management should be the foremost standard
for all healthy women with normal pregnancies, used by all practitioners
(physicians and midwives) and for all birth settings (home, hospital,
birth center). This “social model” of normal childbirth includes the
appropriate use of obstetrical intervention for complications or
at the mother’s request.

(1)
We need your help to elevate the public's awareness of these
problems. We need legislative hearings that will publicly look into the
ever-climbing induction, cesarean section and maternal mortality rates,
the off-label use of Cytotec for labor induction, the danger of promoting
the ‘maternal choice’ cesarean as the so-called ‘ideal’ form of
childbirth, lack of access to VBAC services and the physically damaging
effects on the pelvic floor and pelvic organs associated with the current,
medically-interventive & anti-gravitational management of vaginal birth.

We also need new legislation that would physicians to obtain true informed
consent before substituting medical and surgical interventions in place of
the safer, evidence-based principles of physiological management and that
full information be provided about the risks of medical or surgical
interventions and the mother’s consent obtained before being used during
labor.

(2) I ask that you make evidence-based,
safe and affordable wellness care for women from pre-conception through
birth (and beyond!) a priority and focus of your great influence. I ask you to support the development and
integration of trained and experienced midwives (as done in many
westernized countries) into our health care system to increase
physiological, safe birth and the accompanying satisfaction and decrease
health care costs. Doing so has proven to lower the incidence of
maternal and infant mortality in many other countries around the world.

(3)We hope that you would agree to meet with a
small number of women who have compelling personal stories to share with
you and to discuss how to proceed with the efforts of CEO to bring about
meaningful dialogue between women and obstetricians.